Hope, the Fifth Vital Sign

GW’s MD Class of 2023 Learns One Final Lesson at Their Graduation and Diploma Ceremony — The Fifth Vital Sign, Hope
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At the MD Graduation and Diploma Ceremony, held in Lisner Auditorium, George Washington University (GW) MD graduates arrived with the knowledge they had gained over the last four years in medical school. Most felt that they were versed in the vital signs that they were required to know to assess and address the health and wellbeing of their patients. However, the event’s keynote speaker, Edward Barksdale Jr., MD, the Robert J. Izant Jr., MD, Professor and Surgeon-in-Chief at Rainbow Babies and Children’s Hospital/University Hospitals and Case Western Reserve School of Medicine, introduced to them a “fifth vital sign” – hope.

Barksdale described “hope” as a trait necessary for survival. He told the story of when he first learned about the “fifth vital sign” – from a grandmother of a boy in Nicaragua, who was severely injured after falling out of a tree. The classroom where Barksdale learned this lesson was not a hospital or a clinic, but rather a dirt floor – one the grandmother swept and tried to make as clean as possible before the arrival of Barksdale and the other doctors, who were there to see her grandson. She called the doctors “a miracle” and through her eyes, the doctors could see that she had hoped for this day; hoped for someone to come to the village to help the boy. Upon examination, the physicians determined the injuries were severe enough that the child would not have a positive outcome without intervention. They returned to their respective hospitals to raise funds to bring to boy to the United States and perform the surgery necessary to offer him a chance at a normal life. Barksdale believes that because the circumstances that led to him visiting the village where the boy was lived were so happenstantial, it was the grandmother’s hope that cured the boy, a hope that never waned.

Barksdale told the graduates that because of this experience, he is attuned to his patients and that he, himself, never loses hope. He noted that “hope is the default posture … . As physicians, we can teach people to have hope.” He charged the graduates to be purveyors of hope, noting that hope is the fuel that enables us to be present for our patients, and present in our own lives and in the lives of others. “When the fuel tank is low, it compromises our ability to thrive.”

As the MD Class of 2023 gathered at Lisner Auditorium for the final time, to receive their doctoral hoods and to collect their diplomas, they learned this important lesson, which was witnessed by their families and friends.

As with the tradition of the event, it began with a procession lead by bagpipers, which set the celebratory yet serious tone of the event. The ceremony was steeped with words of advice and motivating sentiments from leaders, including President Mark S. Wrighton, PhD, and fellow students, alike.

GW School of Medicine and Health Sciences Dean Barbara L. Bass, MD, RESD ’86, FACS, noted that her congratulations “are coupled to pride as the dean of this school, knowing that we are now delivering to our public – our city, our region, our nation, and yes, our world, a new cohort of physicians that will go on to be invaluable contributors to the health of the patients and communities you will serve.”

Bass, who also serves as Walter A. Bloedorn Chair of Administrative Medicine, vice president for health affairs, and CEO of the GW Medical Faculty Associates, charged the graduates “to serve with compassion, integrity, and wisdom – using your immense innate talents, the great education you have received here at George Washington, and your commitment to serve others - to go forward and serve as a trusted physician in your many years to come.”

Additionally, Jacob Nassar, MD ’23, the student selected by his classmates to address the class, said that his first exposure to medicine was when his grandfather took care of him as a child when he was sick. From that experience, he learned the valuable lessons of what it takes to take care of someone who is loved. Nassar charged his fellow classmates with always remembering the “Golden Rule 2.0 – treat your patients how you’d want your mom, dad, grandma treated.” He also said that “as difficult as residency will be – we have to stay true to the lessons we learned in early years.”

He noted that he found role models in each of his classmates who always motivate each other to be the best version of themselves. He also said that he can’t wait to see what each of his classmates will do in the years ahead.

Following the graduation programming of the day, all medical doctors in the room, including the newest group of GW MD alumni — the Class of 2023 — were invited to recite the Oath of Hippocrates that memorialized their dedication to each other as physicians, to their patients, and to the practice of medicine.

Finally, as the GW SMHS tradition goes, the class processed out of Lisner Auditorium behind the faculty and a trio of bagpipers to begin the next step in their medical careers.

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